National Provider Identifier [NPI]: |
1205988573 |
Last Name Of The Provider |
SHEPARD |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
211 SAINT FRANCIS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
CAPE GIRARDEAU |
Zip Code Of The Provider |
637035049 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
1285 |
Number Of Medicare Beneficiaries |
510 |
Total Submitted Charge Amount |
404891 |
Total Medicare Allowed Amount |
107260.64 |
Total Medicare Payment Amount |
81645.73 |
Total Medicare Standardized Payment Amount |
85955.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
1285 |
Number Of Medicare Beneficiaries With Medical Services |
510 |
Total Medical Submitted Charge Amount |
404891 |
Total Medical Medicare Allowed Amount |
107260.64 |
Total Medical Medicare Payment Amount |
81645.73 |
Total Medical Medicare Standardized Payment Amount |
85955.56 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
103 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
116 |
Number Of Female Beneficiaries |
285 |
Number Of Male Beneficiaries |
225 |
Number Of Non Hispanic White Beneficiaries |
466 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
313 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
197 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
53 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.0724 |